How does pyelonephritis manifest: clinical picture. Pyelonephritis - what is it, symptoms and treatment

Pyelonephritis is a severe infectious disease that can be caused by various pathogenic microorganisms. Determining the specific pathogen and selecting antibacterial therapy is the main method of treating this pathology. The cause of the development of the disease is often a violation of the passage of urine, nephrolithiasis and other abnormalities in the functioning of the urinary system.

In this regard, treatment of pyelonephritis must also necessarily include measures to eliminate the etiological factor to prevent future relapses of inflammatory processes in the kidneys. Applicable therapeutic methods are selected taking into account the severity of the disease, the nature of the course, the presence of complications, as well as the characteristics of the patient’s health condition. In acute forms of pyelonephritis or exacerbations, treatment should be carried out under the strict supervision of specialists.

Treatment of acute pyelonephritis

– this is a serous or purulent inflammation with predominant damage to the renal interstitial tissue. In most cases, the disease develops in only one kidney. The acute course of the disease is characterized by the sudden appearance of severe symptoms such as chills, fever, high temperature, weakness, etc. To avoid consequences, treatment of pyelonephritis should begin immediately and include a set of measures, including taking antibiotics and other drugs, following a diet and bed rest. If necessary, surgical intervention is also used to eliminate the cause of the disease.

Drug therapy

How to treat pyelonephritis and what medications to take? Treatment of acute pyelonephritis is recommended in a hospital setting. In the first days strict bed rest and warmth. Selection drug therapy carried out taking into account the data of bacteriological urine culture, the presence or absence of obstruction urinary tract, functional state kidneys and the severity of inflammation. If the patient has a disturbance in the normal outflow of urine, then first of all measures are taken to restore it.

The main drugs used to treat pyelonephritis are antibiotics. A course of antibacterial therapy to completely destroy pathogenic microorganisms and prevent relapses or transition of the disease to a chronic form is recommended for at least 6 weeks. In the first days, patients are usually prescribed injections. dosage forms, and then transferred to tablets. Given that urine bacterial culture may take several days, a broad-spectrum antibiotic is initially selected empirically and then, based on the results obtained, the drug is changed if necessary. For pyelonephritis, depending on the specific pathogen, the following groups are used: antibacterial agents:

penicillins;
sulfonamides;
cephalosporins;
fluoroquinolones;
pipemidic acid derivatives;
nalidixic acid derivatives;
nitrofuans.

For the treatment of acute forms of pyelonephritis, they are widely used. antibacterial drugs

The main requirements for antibiotics for the treatment of pyelonephritis are:

high bactericidal activity;
minimal nephrotoxicity;
maximum degree of elimination in urine.

The criterion for the effectiveness of antibiotic therapy is the reduction of symptoms, intoxication, improvement of kidney function and the general condition of the patient 2-3 days after the start of treatment. At the end of taking antibiotics, a repeat general and bacteriological urine test is performed to monitor the effectiveness of the prescribed therapy. Can also additionally be used instrumental methods studies to assess the condition of the urinary system: excretory urography, ultrasound, cytoscopy, etc.

Important: If symptoms appear acute inflammation kidneys, the patient must submit urine for bacteriological examination. Identifying pathogenic microorganisms and determining their sensitivity to antibiotics will allow you to choose the right treatment.

If the cause of the development of pyelonephritis is some kind of kidney disease or other organs of the urinary system, then the underlying disease must also be treated.

Diet

Proper nutrition during acute pyelonephritis helps the body cope with the infection and reduces the load on the kidneys. In addition, it is recommended drinking plenty of fluids. Cranberry and lingonberry fruit drinks or rosehip decoction, which have anti-inflammatory and diuretic effects, will be especially useful. Freshly squeezed vegetable or fruit juices are a valuable source of additional vitamins needed by the body during illness. You are allowed to drink mineral water, compotes, green and herbal teas.

In acute form of pyelonephritis, you must adhere to the following dietary rules:

completely eliminate marinades, canned food, spices, and smoked foods;
limit the consumption of baked goods and sweets;
exclude alcohol, carbonated water, strong black tea and coffee;
do not eat fried, fatty, spicy and peppery foods containing pepper, horseradish, garlic;
exclude difficult-to-digest foods (mushrooms, legumes, etc.);
increase the amount of foods that have a diuretic effect (melons, watermelons, apples, zucchini, etc.).

The basis of the diet should initially be fruits and vegetables; after acute inflammation has been relieved, boiled lean meat and dairy products can be introduced.

Advice: If kidney inflammation is accompanied by increased blood pressure, it is recommended to significantly limit or completely eliminate salt intake.

Surgery

Surgical treatment of pyelonephritis is carried out in case of severe purulent kidney damage, which is characterized by the formation of carbuncles and apostemes, in case of ineffectiveness of antibacterial therapy and other conservative methods. Purpose surgical intervention is to stop further progression of the inflammatory process, prevent its spread to a healthy kidney, and remove obstacles to the normal outflow of urine in case of obstruction. In this case, the organ is decapsulated, drained, and the ulcers are opened. At complete defeat organ (purulent-destructive stage), an operation is performed to remove the kidney.

Treatment of chronic pyelonephritis

In approximately 20% of patients, acute pyelonephritis becomes chronic, the course of which is characterized by alternating periods of remission and exacerbations. In case of exacerbation, the same therapeutic methods are used as for acute kidney inflammation. During the period of remission, treatment of chronic pyelonephritis is carried out at home under clinical supervision. At this time, it is necessary to follow a diet, drink decoctions of medicinal herbs and, if possible, undergo rehabilitation in a specialized sanatorium. Once every three months, such patients must visit a doctor, undergo examination and tests.

avoid hypothermia;
adhere to the correct drinking regime;
take measures to prevent colds and infectious diseases;
strengthen immunity;
follow a diet;
empty your bladder regularly (every 3-4 hours);
take prophylactic short courses of antibacterial drugs (in consultation with your doctor);
observe the rules of intimate hygiene.

Advice: If symptoms of exacerbation of chronic pyelonephritis appear, you should immediately consult a doctor.

Traditional methods of treatment

For pyelonephritis treatment folk remedies can be used as an additional method of therapy both during exacerbations and during remission. For this purpose, they are used separately or as part of fees. medicinal herbs, having anti-inflammatory, bactericidal, antiseptic and diuretic effects in the form of decoctions or infusions. Concomitant use folk and traditional methods treatment of pyelonephritis helps speed up the patient’s recovery during exacerbation of the disease. Among those used in medicinal purposes For kidney inflammation, folk remedies are most effective:

juice from knotweed leaves;
propolis oil;
a decoction of a mixture of bearberry leaves, calamus flaxseed, kidney tea, licorice root, birch buds;
oat decoction with milk or water;
infusion of lingonberry leaves, blue cornflower flowers, birch leaves;
a decoction of aspen bark, bearberry, and Siberian elderberry leaves.

Folk remedies for pyelonephritis are used in the composition complex treatment

Fortunately, only a few know firsthand what pyelonephritis is. This disease is associated with damage to the renal pelvis or parenchyma. It wears infectious nature. The disease is caused by pathogenic bacteria.

From the school anatomy course, we all know that the kidneys are a natural blood filter in our body. These paired organs are also responsible for the formation of urine. Two tubes called ureters transport fluid from the kidney to the bladder, and from there it is removed from the body through the urethra. In the majority of cases, the causes of pyelonephritis lie in the spread bacterial infection from Bladder. Pathogenic microorganisms get there ascendingly through the urethra with skin or mucous membrane.

It often happens that bacteria penetrate the kidneys, bypassing the bladder and urethra, without causing an inflammatory process in them. So, what is pyelonephritis? This is a kidney infection that can be acute or chronic.

Brief description, ICD-10 code

Pyelonephritis is assigned a separate number in the International Classification of Diseases, Tenth Revision. The disease is included in the section “Tubulointerstitial kidney diseases” with coding N10-N16. At the same time, separate labeling is assigned to chronic and acute pyelonephritis.

Depending on the form of the course, kidney pathology may have different Clinical signs. Acute pyelonephritis without complications can manifest itself as a sudden development of the inflammatory process. As a rule, its occurrence is associated with an ascending infection, the mechanism of entry into the body that we described above. The most common causative agent of renal pathology is coli.

An untreated acute form of the disease leads to the development of recurrent kidney pathology. And the main mistake patients make is refusing further therapy when symptoms are relieved. Treatment of pyelonephritis involves complete destruction pathogenic microflora in the kidneys and restoration of normal urine flow, and this may take more than one week.

Unlike the acute form, the protracted form of the disease is not as common. Pyelonephritis is detected by ultrasound or urine examination, since the chronic inflammatory process in the kidneys is characterized by an asymptomatic course.

This disease can also be caused by congenital defects in the kidneys. The cause of the disease is considered to be progressive damage and scarring in the tissues. Without appropriate treatment, the disease often leads to kidney failure. Chronic pyelonephritis is often diagnosed at an early age.

Pathogens

The causative agents of pyelonephritis are no different from the bacteria that cause urinary tract infections. In most cases, as already mentioned, the cause of the disease is E. coli. Quite often during the examination of the patient, others are discovered:

Klebsiella;
Proteus;
Staphylococcus aureus;
Enterobacter;
Pseudomonas;
Serratia Citrobacter.

In patients with immunodeficiency and diabetes, the disease can be caused by Candida fungi.

Predisposing factors

For start pathological process The penetration of pathogenic microorganisms alone is not enough. In a person with strong immunity, the body fights back pathogens. A favorable background for the development of pyelonephritis is a disease or condition that causes stagnation of urine in the urinary tract. It is this that promotes the proliferation of bacteria in the urinary tract and weakens the immune system - this is exactly what the pathogen needs. A similar factor is also the presence of a catheter or urine bag in the urinary tract.

As for diseases that prevent the normal flow of urine, they are a large share probabilities lead to pyelonephritis. When to transport biological fluid slows down, bacteria easily penetrate the ureters. Among the reasons that serve as a convenient background for the development of pyelonephritis, it is worth noting:

benign prostatic hypertrophy;
prostate cancer;
malignant tumors bladder (in both sexes);
congenital anomaly development of the urinary tract;
cancers in the renal tract and metastatic kidney lesions;
consequences of radiation or chemical therapy or surgery;
multiple sclerosis and other central nervous system disorders;
polycystic kidney disease;
AIDS;
myeloproliferative pathologies;
diabetes;
complications after organ transplantation.

In addition, those at risk of developing acute pyelonephritis includes patients over 50 years of age. Moreover, women get this disease more often than men. The cause of pyelonephritis in the fairer sex lies in the peculiarities anatomical structure urethra - their urethra is much shorter.

Pyelonephritis is especially dangerous for pregnant women (as are other forms of urinary tract infection). The inflammatory process increases the risk of premature birth.

It cannot be completely ruled out genetic predisposition to renal pathology. For example, vesicoureteral reflux is hereditary disease which is observed in the patient’s blood relatives. Autosomal dominant inheritance is also attributed to polycystic kidney disease.

Symptoms

The characteristic manifestations of the disease may differ in all patients with pyelonephritis (ICD-10 code N10-N16), depending on age, severity of pathology and individual characteristics body. The main symptoms of this disease look like this:

malaise;
low-grade fever;
chills (with acute pyelonephritis);
vomiting and nausea;
pain in pyelonephritis is usually localized under the ribs, in the lower back, radiating to the suprapubic region, iliac fossa;
frequent painful urination;
hematuria;
pungent odor and cloudy color of urine.

In children at an early age, the pathology occurs secretly. Therefore no specific signs there may not be pyelonephritis. Course of acute kidney disease in children it is practically no different from the manifestations infectious lesion urinary tract. Patients in old age On the contrary, the disease is extremely difficult to tolerate. In old age, confusion, incoherent speech, and hallucinations are possible.

The chronic form, as a rule, is characterized by periodically manifesting itself with dull aching pain in the lower back, especially in the winter season.

How to recognize the disease

Diagnosis of pyelonephritis is usually not difficult. To confirm the disease, the doctor examines the patient, paying Special attention to his general appearance, takes measurements of body temperature, heart rate, blood pressure, palpates the abdomen and lower back. In addition, if pyelonephritis is suspected, the specialist will refer the patient to undergo a series of clinical, laboratory and instrumental studies:

Bacteriological culture of urine. The analysis is carried out to determine the pathogen that caused the development of the disease.
Bacteriological blood culture. Such a diagnosis is resorted to only in the presence of pronounced signs of pyelonephritis with a complicated course.
Detailed blood test. The study results paid special attention to creatinine, a byproduct of the normal breakdown of muscle tissue. The substance undergoes renal filtration and leaves the body in urine. The kidney function associated with its processing is called creatinine clearance. In a laboratory examining a patient's blood sample, the glomerular filtration rate is determined - the rate at which blood flows through the kidneys. Normally, the level of creatinine in the blood should not exceed 106 µmol per liter of blood in adult men and 90 µmol in women.
General Laboratory testing of urine almost always indirectly indicates signs of pyelonephritis, which is indicated by the presence of leukocytes and protein in the urine.
Ultrasound. Using ultrasound screening, specialists identify abscesses, the presence of stones in the kidneys, determine the causes of stagnation of urine, and assess the risk of congenital defects of the urinary tract.
CT scan. As a rule, there is no need to undergo a CT scan, but if ultrasound did not allow doctors to see the full picture of the pathological process, this type of study will dot the i’s.

Besides, in diagnostic complex may also include a gynecological examination. The thing is that in women, pyelonephritis is similar to the symptoms of certain venereal diseases.

Treatment of pyelonephritis

Symptoms of the disease can only be eliminated with antibiotics. In the majority of cases, the duration of the course of antibacterial therapy for uncomplicated disease usually does not exceed two weeks.

Antibiotics are administered orally or parenterally, if their release form allows it. The doctor proceeds from the specific situation when choosing this or that drug. Results are taken into account laboratory research for bacteria that provoked the disease, a tendency to allergies, the presence of chronic diseases, age, pregnancy. The following antibiotics are most often prescribed for pyelonephritis:

"Penicillin";
"Trimethoprim";
"Sulfamethoxazole";
"Ciprofloxacin";
"Cefotaxime";
"Cefaclor";
"Cefuroxime";
"Levofloxacin".

To combat the disease in pregnant women, broad-spectrum antibiotics are used in the most severe cases. Nitrofurans are considered a safer alternative to antibiotics. The group of these drugs includes “Furagin” and “Furadonin”.

For prophylactic purposes chronic pyelonephritis they use drugs containing this substance to help prevent relapse, and for exacerbations of the chronic form, Nitroxoline is recommended.

To have an idea of what antibiotics are needed for pyelonephritis caused by a particular pathogen, take into account the table below:

Pathogenic bacteria	Sensitivity to urological antibiotics
Escherichia coli	"Levomycetin", "Ampicillin", "Carbenicillin", "Gentamicin", "Nalidixic acid", "Fosfomycin", "Nolitsin", "Palin"
Enterobacter	"Levomycetin", "Palin", "Nalidixic acid"
	"Carbenicillin", "Nolitsin", "Palin", "Ampicillin", "Gentamicin"
Pseudomonas aeruginosa	"Gentamicin", "Carbenicillin"
Enterococcus	"Tetracycline", "Furadonin", "Ampicillin"
Staphylococcus aureus	"Penicillin", "Ampicillin", "Gentamicin", "Oxacillin", "Methicillin"
Streptococcus	"Carbenicillin", "Ampicillin", "Tetracycline"
Mycoplasma	"Tetracycline", "Erythromycin"

What pyelonephritis is most often becomes known to people with a weakened immune system.

Common Complications

For complications of pyelonephritis that arose against the background of diabetes, urolithiasis, as a result of damage, trauma, anatomical intrauterine abnormalities of the kidneys and pregnancy, hospitalization and inpatient treatment are indicated.

If the disease is accompanied by severe pain, high fever, chills, severe nausea and vomiting, the patient requires emergency health care and taking steps to prevent dehydration. If vomiting occurs, antibiotics are administered intravenously. Persistent fever and chills may also indicate that a kidney infection has spread into the blood.

In isolated cases, pyelonephritis progresses with the formation of a purulent-inflammatory focus - an abscess. If antibacterial treatment does not bring the desired effect, the abscess is opened. The procedure that is performed in this case is called nephrostomy: a special tube is inserted through the skin on the back directly into the inflammation on the kidney and the purulent contents are pumped out.

Folk remedies

In parallel with taking antibacterial drugs for pyelonephritis, doctors often recommend the use of herbs and folk remedies that have an anti-inflammatory and diuretic effect. Herbal medicine is also successfully used in the treatment of chronic kidney disease. Below we give an example of several well-known folk recipes preparation of remedies for pyelonephritis:

Decoction of corn silk. Plant fibers are taken in the amount of two tablespoons and poured with a glass of boiling water. You need to cook in a water bath. Place the bowl with the broth on the stove, cover with a lid and simmer over low heat for about 30 minutes. After this, cool and strain, add a little boiled water. Before use, the product is slightly warmed and shaken.
An infusion of birch buds and yarrow helps relieve symptoms of cystitis and urinary tract infections. To prepare it, you will need dry raw materials. Both components are used in equal proportions (2 tablespoons each) and poured with a liter of boiling water. Then the product is left for a couple of hours to infuse. You need to take half a glass of the drink twice a day, on an empty stomach.
Birch tar. To relieve inflammation in the kidneys, you need to drink a glass of warm milk three times a day containing 5-10 drops of tar. The course of treatment is 2 weeks.
Dill infusion. Finely chopped greens (approximately 10 g) are poured with hot water and, covered with a lid, set aside for an hour. The prepared infusion is drunk three times a day before meals.

Fresh cranberries, as well as cranberry infusions and fruit drinks, have long been known for their diuretic and antimicrobial property. Pregnant women should eat 2-3 handfuls of this berry to prevent pyelonephritis. Measures to prevent the disease also include regular consumption of celery and spinach. These products prevent the development of inflammatory processes in the kidneys, ensuring good fluid outflow and an anti-edematous effect.

Diet nuances

In search of an answer to what pyelonephritis is and how to deal with this disease, it is impossible to ignore the issue of nutrition. With the disease described, it is diet that plays a huge role, essentially determining the patient’s chances of recovery. The patient risks negating the effect of using medications by ignoring simple rules drawing up a daily menu for kidney pyelonephritis.

Nutrition is based on the principles of maximum limitation in the consumption of salt and smoked products. Salt is a mineral that retains fluid in body tissues and contributes to the development of edema due to renal dysfunction. Her daily consumption should not exceed 6 g.

During the period of acute pyelonephritis (or exacerbation of chronic), canned food, fatty, spicy, fried foods, sweets and baked goods are prohibited. Urologists recommend completely abstaining from coffee (natural and instant), carbonated and alcoholic drinks. You need to be careful when including mushrooms and legumes in your diet.

Features of the daily menu and nutrition for pyelonephritis are based on the need for mandatory consumption of diuretic and anti-inflammatory products and herbal decoctions. Teas made from chamomile, rose hips, lingonberries and horsetail, green tea, and still mineral water will be beneficial.

In the summer, if you have kidney disease (pyelonephritis), you need to eat fresh vegetables, fruits, and melons. To stop an exacerbation against the background of a chronic course of the disease, give preference to a vegetable and dairy menu, including low-fat dairy and fermented milk products and dried fruits in your diet. They are enriched with potassium, and this trace element is known to remove salt from the body and maintain muscle tone. Can be consumed in strictly limited quantities butter, cereals, bread. Protein food plant origin it is desirable to minimize.

When preparing salads from fresh vegetables, try to chop everything very finely or grate it, and season the dishes with olive oil. When boiling meat (chicken, rabbit, turkey), it is advisable to drain the first broth a few minutes after boiling and cook the meat in a new broth - this will remove all extractive substances from the tissues.

Prevention of kidney disease

To minimize the likelihood of developing renal pyelonephritis, you must:

Drink several glasses of water every day. This helps flush out pathogenic bacteria from the urinary tract and kidneys, preventing their proliferation.
Promptly treat any inflammatory processes in the body, regardless of their severity.
Eat a balanced diet and give up bad habits, lead an active and healthy lifestyle.
Avoid hypothermia, keep your legs and lower back warm, and do not sit on a cold surface.

If you have problems with the urinary system, you should not delay treatment. Advanced pathologies often require surgical intervention to restore satisfactory function genitourinary system and preventing future relapses.

Kidney pyelonephritis is an inflammatory disease that occurs in acute or chronic form. An infectious and inflammatory process develops in the kidney parenchyma and the pyelocaliceal system.

What is kidney inflammation, what gives impetus to the inflammatory process? Everything about organ inflammation and treatment options in each specific case can be learned with the help of diagnostics and medical specialists.

Symptoms

People with weakened immune systems are most susceptible to disease.

How does the disease manifest itself? Symptoms of pyelonephritis and patient complaints vary and depend on the person’s age.

A symptom of the sluggish latent period of the disease is the inflammatory process. Signs of pyelonephritis in adults are divided into local and general. At the first signs you should seek medical help.

Pathology can manifest itself with the following symptoms:

Malaise;
Fever, increased body temperature to 39;
The appearance of nausea and vomiting;
Pain in the lumbar region, radiating to the iliac fossa or suprapubic region;
Confusion;
Frequent, painful urination;
Blood in the urine;
Cloudy urine with a pungent odor.

Urinary dysfunction discomfort when urinating, frequent lower back pain may be serious signals diseases.

The disease is often accompanied by diuretic disorders. Night diuresis predominates over daytime diuresis.
An acute form of kidney inflammation manifests itself:

High fever, chills;
Heavy sweating;
Pain from the diseased organ;
On days 3-5, upon palpation, you can notice that the affected kidney is enlarged;
The appearance of pus in the urine on the third day;
Headache, joint pain.

Symptoms of chronic pyelonephritis are not clearly visible. Among characteristic features in this case the following are observed:

Frequent urination;
Unpleasant urine odor;
Constant It's a dull pain in the lumbar region.

At late stages Kidney disease manifests itself:

Dry mouth;
Heartburn;
Belching;
Swelling of the face.

Nausea, severe pain, swelling of the face and legs, arterial pressure above normal - all this can happen serious signs launched chronic process.

Pyelonephritis in children and infants is often confused with ARVI or a cold, which complicates diagnosis and treatment. The sooner the symptoms appear, an examination is carried out and treatment is prescribed, the sooner the problem can be solved.

The identified symptoms and diagnostic results determine the treatment of the disease.

Causes

What causes pyelonephritis? The source of the disease is most often an infection caused by microorganisms. The classification is based on the pathogenesis of the disease.

The main causes of pyelonephritis are well known. The etiology of pyelonephritis and pathogenesis are associated with the penetration of pathogenic microorganisms along with the bloodstream into the vascular system of the renal glomeruli. The main pathogen is Escherichia coli, as well as staphylococcus, streptococcus and enterococcus. The etiological factor causing the chronic process is microbial flora.

The development of pathology occurs when:

System anomalies;
Chronic kidney disease;
Presence of stones in the organ;
Exacerbations during pregnancy;
Adenoma or prostate cancer in men;
Diabetes mellitus of the first or second type;
Gout;
Severe hypothermia of organs;
Long-term use of antibiotics;
Protracted infectious diseases of other organ systems.

The exact causes of the disease are determined by a nephrologist.

The most significant risk factors for pyelonephritis are reflux at various levels.

The psychosomatics of kidney diseases has also been studied quite well. It is important to understand why the inflammatory process in the kidneys can be dangerous. Each new exacerbation of pyelonephritis involves more and more new areas of kidney tissue in the inflammatory process.

Classification

The most common renal pathologies are urolithiasis disease, nephropathy, pyelonephritis, glomerulonephritis.

There is no unified classification of such processes. Most criteria describe the types of pyelonephritis and the nature of the inflammatory process. The most common is the classification according to N. A. Lopatkin.

Hematogenous. The infection is carried by blood to the kidneys from other organs;
Urogenic or ascending. The penetration of bacteria into the kidney tissue occurs from the urinary tract.

According to the nature of the disease, pyelonephritis is classified into acute and chronic. The acute form has a short period with bright severe symptoms and requires hospitalization. More often, patients are diagnosed with a right-sided acute inflammatory process than a unilateral left one. Acute period always begins with serous inflammation. The acute serous period is the initial stage of the disease.

The chronic form can last a long time. There is a classification of chronic pyelonephritis according to the activity of the inflammatory process in the kidney.

About 1% of people with kidney infections develop xanthogranulomatous pyelonephritis, a rare aggressive lesion of the reticular connective tissue with destruction of the parenchyma that results chronic inflammation.

A rare form of acute purulent kidney disease - emphysematous pyelonephritis - is a severe, life-threatening disease characterized by the presence of renal parenchymal and perirenal infection caused by gas-forming microorganisms.

Diagnostics

Diagnosis of acute kidney inflammation is usually not difficult. The symptoms of this disease are well known. The results of blood and urine tests in this case are abnormal. Multiple white blood cells usually appear as a sign of an inflammatory process.

Diagnosis of urinary system diseases includes:

Detailed blood test;
General urine analysis;
Blood chemistry;
Bacterial culture of urine.

First of all, the color of the urine is assessed. The smell of urine is of particular importance. Bacteriological tests of urine identify the causative agent of the disease.

To determine a more accurate cause of the disease, the following procedures are performed:

Ultrasonography;
X-ray (without contrast or contrast urography);
CT and MRI.

Differential diagnosis of acute and chronic pathology carried out with several diseases. There is a special table that presents distinctive features every pathology.

The diagnosis will determine which doctor treats this disease and what appropriate treatment will be prescribed by the specialist.

Special forms of diagnostics corresponding to different types pyelonephritis does not exist. Even xanthogranulomatous pyelonephritis can be recognized and detected using ultrasound. Emphysematous is diagnosed based on data x-ray examination urinary tract and bacteriological examination of urine.

The results of the examination will enable the doctor to make the correct diagnosis.

Treatment

The clinical picture of pyelonephritis can vary from latent, erased, asymptomatic forms to manifest forms, including urosepsis.

Attack renal colic may start suddenly. Inflammation of the kidneys may be accompanied by microhematuria or hematuria, which is defined as blood in the urine.

Treatment of pyelonephritis with acute course carried out using antibiotics. Antibacterial therapy treatment is prescribed only by a doctor. Treatment is started with antibiotics and chemical antibacterial drugs, which must be prescribed taking into account the sensitivity of the urine microflora. Often in such cases Amoxicillin with clavulanic acid, Suprax, Tsiprolet are used. Flemoxin Solutab is used to treat children and pregnant women.

In difficult cases, the drug Levofloxacin and Ceftriaxone are used. Analgesics - painkillers, non-steroidal anti-inflammatory, antispasmodic medications - help relieve symptoms. The most effective medicine Norbactin is considered for cystitis and pyelonephritis.

The standard of treatment and how many days sick leave lasts for pyelonephritis are known. A certificate of incapacity for work is issued to the patient for the time he is in the hospital - from 5 to 10 days.

How to cure chronic pyelonephritis

The disease must be treated comprehensively. The choice of treatment will depend on the stage, form and severity of the pathology. Manifestation syndromes are carefully studied.

Treatment of a chronic process in both the right and left kidneys takes quite a long time. For this purpose, various anti-infective drugs are used - uroantiseptics. One of the most commonly used uroseptics is Nitroxoline. The cleansing function of the kidneys is activated by the drug Fitolysin.

To treat this disease, you can and should use folk remedies. Herbs significantly help in the therapy process, providing anti-inflammatory, uroseptic, and diuretic effects. The most popular means for inflammation in the kidneys, there are leaves and berries of lingonberry, leaves and buds of birch, cornflower, bearberry. Rosehip is used to strengthen the immune system.

Homeopathy improves all kidney functions.

During the recovery period and to prevent the disease, procedures are prescribed by a physiotherapist to increase the body's defenses. Physiotherapy and immunostimulation are carried out. Rehabilitation for pyelonephritis, restoration of the body and treatment chronic disease can happen at home.

Xanthogranulomatous

Xanthogranulomatous pyelonephritis is most often treated only with surgery. Another disease associated with kidney inflammation is glamic nephritis, which, despite the seriousness of the disease, is usually treated with supportive care. The difference between glomerulonephritis and pyelonephritis is that the pathological phenomena gradually spread and affect the calyces and pelvis of the kidneys.

Spicy

Treatment for acute kidney pyelonephritis takes place mainly in a hospital. This is dictated by the need for constant monitoring of the patient, monitoring his condition, taking multiple tests and monitoring the dynamics of the disease. This difficult work is performed by nurses.

To begin the nursing process of caring for a patient, it is necessary to ask the patient or his relatives about the problem, medical history, past illnesses, and objective research- this will allow the nurse to assess the physical and mental condition patient.

Literate nursing care– a great help for the patient and speeding up the healing process. Nursing process includes the execution of certain actions:

Follow the instructions of the attending physician;
Collect patient tests in a timely manner;
Monitor the patient’s compliance with the diet prescribed by the doctor;
Maintain thermal conditions in the ward;
Monitor compliance with bed rest;
Provide emotional support to the patient;
Monitor the patient’s condition and, if necessary, provide first aid;
Promptly notify the doctor about the patient's condition.

There is no clear answer to the question whether chronic pyelonephritis can be completely cured. Which doctor treats this disease?

How to treat pyelonephritis in each specific case can be found out at an appointment with a doctor, after carrying out the appropriate diagnosis. Kidney disease in men and women is treated by a nephrologist, urologist, a therapist is also directly involved in this process, and in children - by a pediatrician.

Louise Hay explains kidney disease in the field of psychosomatics. For treatment renal pathologies It is recommended to pay attention to this point of view.

Is pyelonephritis congenital?

The structural features of the genitourinary system in a newborn can be provocateurs of pyelonephritis.

Dr. Komarovsky warns that pyelonephritis in newborns and infants up to one year old is dangerous with complications, so diagnosis and treatment should be carried out as quickly as possible.

Are the concepts compatible: pyelonephritis and the army? Do people with chronic pyelonephritis join the army? It all depends on the course of the disease. Even a doctor’s conclusion about the presence of such a diagnosis does not guarantee exemption from military duty. A decision on the eligibility of a conscript will be made in accordance with the conditions prescribed in the Schedule of Sicknesses.

An important point in the treatment of kidney inflammation is diet. If the disease is only in the initial stage, to treat it, you can try a decoction of oats in combination with the diet prescribed by the doctor. Oats can also be brewed to prevent disease. Oatmeal infusions also strengthen the body's immunity. In order to avoid the onset of the disease, prevent progression and speed up treatment, doctors usually prescribe massage for pyelonephritis and exercise therapy.

Is it possible to go to the bathhouse with pyelonephritis to improve the health of the body?

But bathhouses and saunas are not always indicated in such a situation. You should consult your doctor on this issue.

It is possible to get rid of the inflammatory process in the kidneys with timely examination and treatment, as well as following an appropriate diet and a healthy lifestyle. Complications in this case can lead to serious consequences. One of these complications, although quite rare, is xanthogranulomatous pyelonephritis. As a result of complications, hypertension and diseases of other organs and systems may appear.

Diet

What can you eat if you have pyelonephritis? The acute period of the disease, chronic, xanthogranulomatous and emphysematous pyelonephritis require a special diet.

If you have inflammatory kidney disease, you need to drink plenty of fluids. Mineral water, which must be drunk according to a certain scheme, must be present in the diet. You need to eat right and lead a healthy lifestyle. The diet is usually agreed upon with the attending physician, but, as a rule, fatty, spicy, and fried foods are excluded from the diet. Salt consumption should be kept to a minimum.

Diet for pyelonephritis is an important direction in the treatment of the disease, as it helps reduce the load on the affected kidneys and replenish the body important vitamins and minerals, which is necessary measure in the process of increasing immunity.

Complications

Frequent exacerbations of the disease do not pass without leaving a trace, and the disease recurs again and again, moving into the chronic phase, causing complications to appear.

In the absence of timely treatment for pyelonephritis, the disease can lead to serious complications.

The destruction of kidney tissue caused by inflammation can not only aggravate the functioning of the organ, but also make it absolutely impossible. Serious consequences pyelonephritis - xanthogranulomatous, emphysematous pyelonephritis and renal failure. Complications affect all organs and systems of the body.

Pyelonephritis is one of the most common infectious diseases of the kidneys, accompanied by the development of an inflammatory process in the pelvis, calyces or parenchyma of the organ. It can occur independently or as a concomitant complication against the background of other pathologies (nephrolithiasis, glomerulonephritis, etc.).

The causative agents of infection are most often pathogenic or opportunistic gram-negative microorganisms that can enter the kidneys in various ways. Timely consultation with a doctor and adequate therapy reduce the risk of developing possible complications and the transition of the pathology to a chronic form. The incidence rate is about 1% among adults and 0.5% among children. In more than half of the clinical cases, kidney pyelonephritis is detected in young and middle-aged women.

Causes

The main reason for the development of pyelonephritis is the appearance of potential pathogens of infectious diseases in the kidneys. These can be microorganisms that constantly live in the body or come from outside.

There are three ways infection can enter the kidneys:

Hematogenous. Infectious agents enter the kidneys with the blood when there are foci of acute or chronic inflammation in the body. For example, sinusitis, tonsillitis, furunculosis, osteomyelitis, influenza, tonsillitis, etc.;
Lymphogenic. Pathogenic microorganisms enter the kidney from the nearest organs affected by infection (intestines, genitals, etc.) through the lymph flow;
Urinogenic. The pathogen enters the organ from lower sections urinary system– bladder or ureters. This mechanism of infection occurs when the patient has vesicoureteral reflux (return of urine from the bladder into the ureters).

Among the most frequently detected bacterial culture The following microorganisms are present in the urine of pyelonephritis pathogens:

Enterococci;
Paraintestinal coli;
Pseudomonas aeruginosa;
Proteas;
Streptococci;
Klebsiella;
Staphylococci.

In approximately 20% of cases, patients with pyelonephritis have a mixed pathogenic microflora, rather than one specific pathogen. With a long course of the disease, there are cases of fungal infection.

Escherichia coli is the most common causative agent of pyelonephritis

Important: Penetration of a potential pathogen into the kidney does not always lead to pyelonephritis. In addition, the body must have favorable conditions for active growth, vital activity and reproduction of the infectious agent.

For the development of pyelonephritis, reasons are necessary that promote the reproduction and active functioning of pathogenic microflora in the kidneys. These include the following conditions:

disturbance of urodynamics due to nephroptosis, kidney dystopia, the presence of stones in the organs of the urinary system and other factors;
hypovitaminosis;
decreased immunity;
hypothermia;
pathologies of the endocrine system (for example, diabetes mellitus);
frequent nervous stress;
chronic inflammatory diseases;
weakness, fatigue.

An increased risk of developing kidney pyelonephritis is observed in children under 6 years of age, which is explained by the structural features of the urinary tract and an incompletely formed immune system. Quite often, the disease is detected in women during pregnancy against the background of reduced immunity, compression and weakening of the tone of the urinary tract. Also at risk are men over 60 years of age suffering from prostatitis, urethritis or prostate adenoma.

Types of disease

IN medical practice There are several principles for classifying the disease. Based on the localization of the inflammatory process, unilateral and bilateral pyelonephritis is distinguished. Taking into account etiological factors There are primary (in the absence of any kidney pathologies and urodynamic disorders) and secondary forms of the disease. Depending on the presence of obstructions in the urinary tract, kidney disease pyelonephritis can be obstructive or non-obstructive. The most commonly used classification of pyelonephritis is based on the nature of its course. According to this criterion, acute and chronic forms of the disease are distinguished.

Acute pyelonephritis

Acute pyelonephritis can occur in two forms - serous and purulent. In this case, the inflammatory process is localized mainly in the interstitial tissue.

With serous pyelonephritis, the organ increases in size and acquires a dark red color. Multiple infiltrates are formed in the interstitial tissue, alternating with healthy renal tissue. There is swelling of the interstitial tissue, accompanied by compression of the renal tubules. In some cases, inflammation and swelling of the perirenal fatty tissue is also noted. With timely and adequate treatment, the disease reverses. In severe cases, serous pyelonephritis can become purulent.

Purulent pyelonephritis is characterized by the presence in the interstitial tissue large quantity pustules of various sizes. Small pustules can join together to form a carbuncle - a large abscess. When the ulcers spontaneously open, the pus enters the renal pelvis and is excreted along with the urine. During recovery, connective tissue forms at the site of the ulcers, forming scars. The degree of involvement of certain parts of the organ in the inflammatory process depends on the route of infection. With the urinogenic route, more pronounced changes are observed in the pelvis and calyx, and with the hematogenous route of infection, the cortex is primarily affected.

Chronic pyelonephritis

Chronic kidney pyelonephritis is most often the result of an untreated acute form of the disease. The inflammatory process covers individual areas of the kidney in the lower or upper pole. The course of chronic pyelonephritis is characterized by alternating periods of remission and exacerbations. With each exacerbation, new areas of renal tissue are involved in the inflammatory process. As the disease progresses, there is a dysfunction of the glomeruli and tubules, which is fraught with the development of renal failure

Against the background of chronic pyelonephritis, the development of nephrogenic arterial hypertension is often noted. In the final stage of the disease, patients present with a shriveled kidney, scarring, and replacement of tubules connective tissue. The prognosis of the disease depends on its duration, the activity of the inflammatory process and the number of exacerbations.

Important: The diagnosis of chronic pyelonephritis is made if clinical and laboratory signs are observed for more than one year.
Prevention methods
Prevention of pyelonephritis is not complicated, but, nevertheless, it allows you to reduce the risk of the disease and its severe consequences. It includes the following steps:
timely treatment of any infectious diseases;
drinking at least 1.5 liters of fluid per day for the normal functioning of the urinary system;
timely (without long delays) emptying the bladder;
daily observance of personal hygiene rules.

Also, to prevent the occurrence of the disease, it is important to avoid hypothermia, as it often becomes a provoking factor for the spread of infection.
Maintaining physical fitness, giving up bad habits, a balanced healthy diet, including all the necessary vitamins, macro- and microelements, help strengthen the body as a whole and increase its resistance to various diseases, including pyelonephritis.
People who are predisposed to developing the disease need to be regularly monitored by a nephrologist and undergo urine tests to assess kidney function and promptly identify any abnormalities.
Advice: Prevention of pyelonephritis should begin from the very beginning. early age, since children under six years of age are at risk.

– insidious disease, which is characterized by the development of an inflammatory process of the renal pelvis and kidneys. This disease often develops in humans both as an independent disease and as a consequence of other diseases of the genitourinary system, due to which the flow of urine is disrupted in a person. So, very often the development happening in the background, prostate gland , often the disease can develop against the background of illnesses that are infectious in nature.

Pyelonephritis in children often develops as a complication after an illness , pneumonia . In pregnant women, this disease is a consequence of palpable hormonal imbalance in the body, and also develops due to impaired outflow of urine due to compression internal organs uterus. Moreover, during pregnancy exacerbation of chronic pyelonephritis often occurs.

Pathogenesis (what happens)

The development of pyelonephritis occurs when pathogenic microbes enter the kidney tissue. In patients, either they pass from the bladder through the ureters. Germs can also spread throughout blood vessels from different foci of inflammation throughout the body.

- a disease that mostly affects women. With pyelonephritis, an inflammatory process of one or both kidneys manifests itself. As a rule, the disease is bacterial in nature. Microorganisms enter the human kidneys from the source of infection in the body through the bloodstream, or from the bladder and urethra through the ureters. In the latter case, kidney pyelonephritis manifests itself as a complication after or .

The prevalence of the disease among girls and women is explained, first of all, by the fact that the urethra in females is shorter than in males. Very often, symptoms of pyelonephritis appear in people who have problems with work immune system, y diabetics . The disease often occurs in children preschool age. Pyelonephritis often occurs in pregnant women, as well as in those who have already experienced or starts sex life. In men, the factor that provokes the development of kidney pyelonephritis is often prostate gland . Due to problems with the outflow of urine in a person, a favorable environment for the development of bacteria is created in the body. Patients with pyelonephritis also suffer from kidney stones . Such formations often become a refuge for bacteria, which subsequently provoke inflammation.

Types of pyelonephritis

Kidney pyelonephritis is usually divided into spicy And chronic . There is also primary And secondary form of the disease.

It is customary to distinguish acute And chronic form of pyelonephritis. In acute pyelonephritis, a person suffers from very severe chills, with intense sweating, an increase in body temperature up to forty degrees, pain in the lumbar region, nausea and vomiting. Urine analysis reveals a significant number of microbes and .

Unlike acute pyelonephritis chronic form The disease can go on silently for years. At the same time, there are no obvious symptoms of pyelonephritis in humans, and signs of the disease can only be detected during a urine test. As the disease progresses, it can periodically become severely aggravated. Then the signs of the disease will be similar to the symptoms of the acute form of the disease. Treatment of chronic pyelonephritis must be adequate and timely, otherwise the excretory function of the kidneys may be significantly impaired.

Acute pyelonephritis

Acute pyelonephritis occurs in the patient due to effects on his body endogenous or exogenous microorganisms that penetrate the kidneys. In this case, a number of factors are decisive in the development of the disease: impaired urine passage due to stone obstruction and other reasons; obstruction of urine flow due to adenomas , prostate cancer , etc. In addition, the occurrence of pyelonephritis determines general state human body. The body's resistance is negatively affected by an incorrect approach to nutrition, hypothermia, hypovitaminosis , frequent colds, ailments of a number of body systems.

Depending on the stage of the disease and the presence of its complications, symptoms of pyelonephritis appear. Determination of the stages of the disease occurs after studying the morphological changes in the kidney.

At the initial stage of the disease, a person suffers from serous pyelonephritis , which can last from six to thirty-six hours. The disease then progresses to the following stages, which are characterized by the presence of purulent, destructive changes. As a rule, such changes have a clear sequence. First appears apostematous pyelonephritis , Further - kidney carbuncle , kidneys , and the process of change ends purulent paranephritis.

On the stage apostematous pyelonephritis in humans, small multiple pustules appear on the surface of the kidney and in its cortex. If these pustules begin to merge during development, or a microbial embolus ends up in the final arterial vessel of the kidney, a person develops a renal carbuncle. This condition is characterized by the development necrotic , ischemic , purulent-inflammatory processes.

Due to purulent melting of the parenchyma, kidney abscess . , which appeared in the focus of a renal carbuncle or apostemal fusion, is sometimes emptied into the perinephric tissue. After this it develops purulent paranephritis , sometimes phlegmon of the retroperitoneal space also occurs.

Most often purulent forms pyelonephritis occurs as a consequence of obstruction of the upper urinary tract.

At secondary acute pyelonephritis local symptoms of the disease appear more clearly. At the same time, in the process of development primary pyelonephritis , first of all, there are general signs infections, but local symptoms may not appear at all at first. As a result, errors are possible during the diagnostic process. Symptoms of pyelonephritis generally become noticeable throughout the day. The patient complains about general weakness and malaise, against the background of which occurs severe chills, body temperature can rise to 41 °C. Chills are characterized by severe headache, vomiting and nausea. A noticeable muscle pain occurs in the body, sometimes annoying the patient diarrhea , .

Secondary acute pyelonephritis begins with the manifestation of renal colic. After this, chills appear, against the background sharp jump body temperature, which can rise to 41 ° C. Next, the patient develops symptoms similar to those of secondary pyelonephritis. After the temperature drops to normal or subnormal levels, the person begins to sweat profusely. He feels a certain improvement, the pain in the lower back becomes less intense. However, in this case there is an imaginary improvement, which the doctor cannot regard as a cure for the patient. Indeed, in the case of obstruction of the upper urinary tract, the attack of pain and chills will resume after a few hours.

If the patient develops purulent form of pyelonephritis , then the symptoms of the disease become even more pronounced. In this case, lumbar pain goes from paroxysmal to constant, it is accompanied by chills and. On the side where the lesion is observed, the muscles of the anterior abdominal wall are tense and lumbar region. The kidney is painful; palpation reveals its enlargement. It increases in the body intoxication , as a result of which the person’s condition becomes worse. The state of dehydration gradually worsens, so a person’s facial features become noticeably sharper, the condition becomes severe, and in some cases is accompanied by. However, the described symptoms of kidney pyelonephritis with purulent-destructive changes in the kidney are not always expressed. If a person is weakened or sick, then clinically the condition may manifest itself perversely.

Chronic pyelonephritis

Chronic pyelonephritis is a fairly widespread disease. However, such a diagnosis is quite difficult to establish due to very few pronounced general clinical symptoms. In most cases, chronic pyelonephritis is a continuation of acute pyelonephritis. This disease occurs especially often in those patients who have impaired upper urinary tract passage of urine. This phenomenon is provoked by stones in the ureters and kidneys, chronic urinary retention and other phenomena.

About a third of patients suffer from chronic pyelonephritis since childhood: the disease develops as a nonspecific sluggish inflammation of the parenchyma of the pyelocaliceal system and the kidney. In most cases, the disease is discovered many years after it occurs. Chronic pyelonephritis affects both one and two kidneys.

This disease is characterized by polymorphism and focal changes in the kidney tissue. Gradually, the following areas of the kidney tissue are involved in inflammation, therefore, the tissue gradually dies, and .

The manifestation of chronic pyelonephritis is wavy: exacerbations of the disease periodically occur, which are replaced by remissions. Depending on the spread of inflammation in the kidneys and its activity, the clinical picture may vary. When active inflammatory process symptoms similar to those of acute pyelonephritis. When the period of remission begins, the manifestations of pyelonephritis are expressed nonspecific signs. So, a person can complain about headache, lack of appetite, weakness, chills, attacks of nausea and periodic jumps in body temperature to subfebrile. In some cases, a dull pain occurs in the lower back.

With subsequent progression of the disease, the person complains of seizures arterial hypertension . Ten to fifteen years from the onset of the disease, the patient develops chronic renal failure .

Diagnosis of pyelonephritis

In order to correctly diagnose kidney pyelonephritis in a patient, the doctor first of all examines the patient, paying special attention to the condition of his skin, noting whether there is moisture and pallor of the skin. The doctor also notes a dry, coated tongue and determines the presence tachycardia , hypotension .

Laboratory blood tests reveal leukocytosis , acceleration. If purulent forms of the disease occur, the patient experiences dysproteinemia , anemia , high level serum urea and creatinine. Also, during the diagnostic process, a urine test is mandatory. It is important to conduct a bacteriological study and determine the sensitivity of microorganisms to antibacterial drugs. Laboratory studies must include bacteriological culture urine.

As additional methods Ultrasound diagnostics of the kidneys is often prescribed. If during this examination limited mobility of the kidney is observed, then this sign can be regarded as an additional criterion in the process of diagnosing acute pyelonephritis. Thanks to ultrasound, it is possible not only to diagnose the disease, but also to determine the reasons that led to its appearance - the presence of kidney stones, defects of the urinary system.

It is also possible to accurately determine the destructive forms of pyelonephritis in children and adults using CT or MRI.

If it is not possible to perform ultrasound diagnostics It is possible to differentiate primary and secondary pyelonephritis based on the results of chromocystoscopy and excretory urography. In acute pyelonephritis, it is important to carry out a differential diagnosis with infectious diseases, acute ailments of the genitals and abdominal organs.

It is very difficult to diagnose chronic pyelonephritis in a person, because this form of the disease has a long latent period. In view of this, it is important to carefully study the results of laboratory tests, even if there are no visible external signs of the disease.

In progress ultrasound examination the only sign that is characteristic of the chronic form of the disease is the presence kidney shrinkage . In this condition, the kidney becomes smaller and its contour becomes uneven.

This condition is also characterized by a decrease in the secretory function of the kidney.

Treatment of pyelonephritis

The manifestation of acute pyelonephritis in children and adults is a reason for immediate hospitalization of the patient and his subsequent treatment in a hospital. However, the treatment of primary and secondary renal pyelonephritis is carried out using different approaches. If a patient is diagnosed with secondary pyelonephritis, the most important action required is to restore the flow of urine from the kidney that has been affected. If the disease began to manifest itself no earlier than two days and there are no purulent-destructive changes in the kidney, then the outflow of urine is restored by catheterization of the pelvis.

After the outflow of urine has been restored, as well as for primary pyelonephritis, pathogenetic treatment is used, the main point of which is the use antibacterial drugs . It is important to prescribe antibacterial drugs that have wide range actions and affecting gram-negative flora.

Drugs for the treatment of pyelonephritis are administered parenterally, using the maximum therapeutic dose. In the process of complex treatment of pyelonephritis, other drugs are also prescribed: non-steroidal anti-inflammatory drugs, drugs that activate blood circulation, and methods of intoxication therapy are also used. If at the right approach After treatment for one and a half days there is no improvement effect, then the doctor concludes that there is a progressive purulent-destructive process in the kidney. This is a direct indication for open surgery.

The operation is performed to stop the purulent-inflammatory process or prevent complications, ensuring improved blood and lymph circulation in the kidney. For this purpose, it is carried out decapsulation kidneys This method helps reduce intrarenal pressure and expand the lumen of blood vessels. If 2/3 or more of the renal parenchyma is involved in the purulent-destructive process, then it is possible to perform nephrectomy during the operation.

As rehabilitation treatment therapy is carried out after surgery antibacterial , anti-inflammatory , detoxification means.

At the beginning of treatment of chronic pyelonephritis, it is important to find out what is the cause of the urinary passage disorder and circulatory disorders. Taking into account the results of bacteriological studies, the doctor prescribes antibacterial agents. To achieve this, several courses of treatment are used, each time using a different drug due to the rapid emergence of resistant strains of microbes. In addition, for the treatment of pyelonephritis, sulfonamides drugs, herbal products, vitamin complex , immunocorrective facilities. Treatment of chronic pyelonephritis lasts at least two months. If chronic pyelonephritis does not respond to treatment, the patient must undergo nephrectomy.

Considering the fact that pyelonephritis is an infectious disease, its therapy is carried out using . Very important point is that treatment of pyelonephritis with antibiotics should only be prescribed by a specialist. Indeed, when choosing a drug, a number of individual characteristics must be taken into account, namely, what type of microorganism provoked the disease, the degree of its sensitivity to a particular drug. The duration of taking the drug, as well as its dosage, is determined taking into account the state of the patient’s kidneys at this moment. Treatment of pyelonephritis with antibiotics will give a faster effect if it is started from the very first day of exacerbation of the disease.

If the patient is diagnosed with a chronic form of the disease, then the treatment of pyelonephritis in this case will be longer: for example, the course of antibiotics is from six to eight weeks. The further approach to therapy is determined by the attending physician.

The doctors

Medicines

Treatment of pyelonephritis at home

In parallel with drug treatment For pyelonephritis, the use of some auxiliary methods and therapies available at home is often practiced. If there is an exacerbation of the disease, it is best for the patient to observe strict bed rest for some time, while constantly staying warm. In this case, blood flow in the kidneys will be activated, and inflammation will subside much faster.

For pyelonephritis, a certain drinking regime: if a person has never suffered arterial hypertension and he does not have edema, he should drink about three liters of fluid every day. In this case, vitamin drinks are recommended, mineral water, fruit drinks, jelly, compotes. The most healthy drinks There will be fruit drinks made from cranberries and lingonberries, because they also have an anti-inflammatory effect.

Compliance with particularly strict not required during treatment: it is enough to avoid spicy and salty foods, alcohol, and smoked foods. At the same time, you need to include in your daily diet as many foods as possible with plenty of vitamins. With pyelonephritis, the body must replenish its supply of potassium, as well as vitamins B, C, P. Foods with diuretic properties are also recommended: pumpkin, melon, watermelon.

Treatment of pyelonephritis with herbs

There are a lot of recipes traditional medicine, which are successfully used to alleviate the condition of a patient diagnosed with pyelonephritis. Herbal treatment involves the use of special mixtures that must be drunk for several days.

One of these collections includes lemon balm herb, knotweed, elderberry flowers, bearberry leaf, St. John's wort, calamus root, kidney tea leaf, fennel fruits.

Another collection for the treatment of pyelonephritis includes chamomile and blue cornflower flowers, common juniper fruits, stinging nettle and peppermint leaves, marshmallow root, flax seeds, tricolor violet grass and prickly tartar.

To prepare these preparations, you need to take three tablespoons of crushed and mixed ingredients, pour half a liter of boiling water and leave for six hours. You need to drink herbal tea warm, half an hour before meals.

In addition, when treating pyelonephritis with folk remedies, it is practiced to use a collection medicinal plants, which have a positive effect on the body's resistance.

This collection of herbs consists of wild strawberries, juniper and rose hips, horsetail grass, birch, plantain, bearberry, black currant, and nettle. To make a decoction, you need to take ten grams of a mixture of herbs, pour boiling water over it and boil in a water bath for thirty minutes. After this, the herbal decoction is infused for another thirty minutes. It should be taken warm, before meals.

To treat pyelonephritis, you can also use a special herbal tea, which is sold in pharmacies. However, you can prepare such a remedy yourself. To do this, you need to combine meadowsweet, raspberry, willow, birch leaves, elderberry, fireweed, celandine, burdock, chamomile, dandelion, lingonberry. This tea is effective in the acute stage of the disease. It can be used for a long time - even several months. To prepare the tea, add two tablespoons of medicinal plants to one liter of water and simmer over low heat for about twenty minutes.

Decoctions of other herbs are also effective remedies for pyelonephritis: you can prepare a tincture of bedstraw herb and toadflax herb. The dried herb is poured with boiling water and boiled in a water bath for 15 minutes.

For patients diagnosed with pyelonephritis, herbal treatment is often practiced together with antibiotic therapy. However, the use of this method must be reported to the doctor.

There are also a number traditional methods, which are additionally used in the treatment of pyelonephritis. As a rule, these are herbal decoctions, which include blackberry leaves, bearberry, flax seed, birch leaf, nettle, and horsetail herb. The decoctions are taken warm several times a day.

Treatment of pyelonephritis with folk remedies includes not only the use of herbal decoctions and infusions. So, with such a disease, taking carrot juice has an effective effect on the general condition of the body. Also, before eating, people with pyelonephritis are recommended to eat about 100 g of grated carrots.

Pyelonephritis in pregnant women

Pyelonephritis in pregnant women often occurs as a result of intensive growth of the uterus, which, as it grows, presses on the ureters and impedes the outflow of urine. In addition, pyelonephritis in pregnant women occurs more often due to noticeable hormonal changes in the woman’s body. Due to intense hormonal changes, ureteric peristalsis may become noticeably more difficult.

In addition, daily activity is important for the proper functioning of the urinary system, which is not always typical for a woman carrying a child.

Most often, pyelonephritis occurs in those pregnant women who have previously had cystitis or pyelonephritis .

It is important to consider that pyelonephritis negatively affects the course of pregnancy and the fetus. This disease can cause anemia, late pregnancy and even termination of pregnancy. Therefore, when symptoms of pyelonephritis appear, it is important for a woman carrying a child to immediately seek medical help.

All women who have suffered pyelonephritis during pregnancy remain under the follow-up supervision of a doctor after childbirth.

Diet, nutrition for pyelonephritis

The diet involves careful selection of diet during the treatment of the disease, and after recovery. In the first days of illness, patients with acute pyelonephritis are advised to eat only berries, fruits, melons, and purees from some vegetables. Later, protein products can be gradually introduced, but a diet for pyelonephritis involves energy value nutrition not higher than 1800-2000 kcal.

In the first days of illness, it is important to drink at least two liters of liquid - weak tea, herbal decoctions, fruit juices diluted with water. It is recommended to use fruit drinks made from lingonberries and cranberries.

A salt-free diet for pyelonephritis is not necessary, but salt intake should be limited to 6 g per day. It is important to eat food with high content vitamins

At the same time, the disease with chronic pyelonephritis does not imply special . However, it is important to follow the principles healthy eating, drink plenty of fluids, do not limit salt intake. To improve the health of the body, you can periodically arrange fasting days.

Complications of pyelonephritis

As complications of pyelonephritis in children and adults, it can develop acute pyelonephritis in the opposite kidney , sepsis , bacteriotoxic shock .

The most serious complication of acute pyelonephritis is bacteriotoxic shock, as a result of which 45 to 55% of patients die. This disease manifests itself when antibacterial agents are prescribed when the outflow of urine is not restored.

In this condition, a person's to critical levels, the return of blood to the heart decreases, destruction occurs And platelets . As a result, processes occur that lead to the development of multiple organ failure.

In chronic pyelonephritis, complications arise nephrogenic arterial hypertension And chronic renal failure .

List of sources

Laurent O.B., Sinyakova L.A. Inflammatory diseases organs of the urinary system. - M.: MIA, 2008.
Pereverzev A.S., Kogan M.I. Infections and inflammation in urology. - M.: ABV-press, 2007.
Tiktinsky O.L. Pyelonephritis / O.L. Tiktinsky, S.N. Kalinina. - St. Petersburg: Media Press, 1996.
Shekhtman M.M. Obstetrics nephrology. M., Triad X, 2000.